Results of percutaneous transluminal valvuloplasty in 218 adults with valvular aortic stenosis

Am J Cardiol. 1988 Sep 15;62(9):598-605. doi: 10.1016/0002-9149(88)90663-7.

Abstract

The results of balloon aortic valvuloplasty (BAV) in 218 adult patients with valvular aortic stenosis (AS) are reported. In most cases, 3 transcutaneously introduced balloons of successively increasing size were used. Tolerance was excellent in 64%, whereas a decrease in blood pressure below 60 mm Hg during inflation was observed in 36%. The left ventricular-aortic peak to peak gradient decreased from 72 +/- 25 to 29 +/- 14 mm Hg (p less than 0.001) and the aortic valve area increased from 0.52 +/- 0.18 to 0.93 +/- 0.33 cm2 (p less than 0.001). The final aortic valve area was greater than or equal to 1 cm2 in 69 patients (32%). In only 6 cases (3%) the aortic valve area did not change or increased by less than 10%. A clear improvement in the results was observed with gained experience and better catheters. There was 1 death and 1 stroke in the procedure room, and 3 strokes after BAV. Nine patients died shortly after the procedure. There were local complications (hematoma or thrombosis) at the femoral puncture site in 28 (13%) patients. Clinical follow-up was obtained for 144 patients (mean 8 months). There were 24 deaths. In the 120 remaining cases, symptomatic improvement was good in 84%, with decrease or disappearance of dyspnea, angina or both. This study demonstrates that BAV is feasible in adult AS at a low risk and is able to produce marked clinical improvement in most cases.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aortic Valve Stenosis / diagnostic imaging
  • Aortic Valve Stenosis / physiopathology
  • Aortic Valve Stenosis / therapy*
  • Cardiac Catheterization
  • Catheterization* / adverse effects
  • Female
  • Follow-Up Studies
  • Hemodynamics
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Radiography